Memento Mori: Death as depicted in medieval art and modern medicine

“Death and the Miser” is a 1561 painting from Hieronymus Bosch that depicts a classical deathbed scene, with the figure of death creeping into a room from a side-door to take the life of the individual sitting on a bed to the right of the painting.

Death takes the form of a skeleton, clad in drab clothing and holding a spear of sorts. It appears unfriendly, cold, but great in stature. A grey piece of cloth twists around Death’s head and carries down to the feet, like an oversized toga, as if the skeleton didn’t deserve the garb it found itself in. Interestingly, Death seems to be moving slowly; it does not seem like it had planned to burst into the room and follow with a quick escape. Instead, it is almost as if death had knocked prior to entering the room.

There are three human-appearing individuals in the room: One in a brown robe, fiddling with something at the foot of the deathbed; another without clothing, tucked underneath the sheets of the deathbed (supposedly the one for whom Death has appeared); and another clad in white touching the shoulder of the soon-to-be deceased and looking directly at Death with an outstretched hand — not welcoming it, but acknowledging it.

It is the relationship between death and this individual clad in white that is of most interest to me.

My mother was an internist at a small hospital outside of Detroit for some years before we moved to the fringes of Ann Arbor. As a specialist in internal medicine, she worked with patients who had been admitted to the hospital and placed under her care.

Working at a smaller, more rural hospital, her case load inevitably involved fewer instances of fast-paced trauma and more instances of elderly patients for whom age was simply taking its medical toll. This, however, never exempted her from a healthy dose of interesting medical stories and life experiences: I grew up in earshot of an innumerable amount of complex medical discussions and consultations that my developing mind couldn’t comprehend.

Over the years of being filtered into the pre-med pool of academia (against the advice of my mother), I heard more and more tales from her residency and practice to attempt to sway me from the grueling track that will be medical school and residency. She recounted experiences of rude patients, changing electronic systems, the threat of depositions. She told me about her long on-call shifts, nightmares about her patients and the pitting feeling of guilt when something didn’t go your way.

One story that has failed to banish itself from my mind and my mother’s involves an on-call shift in 1996. My mother, as an attending internist, was tasked with rounding the entire admitting floor, patients who had been judged as needing more extensive and prolonged medical treatment than the emergency department could provide.

“I had just finished a code when I was called to the floor below me to see a patient,” said my mother upon my request for her to recount the story. A “code” refers to a “code blue,” which denotes a patient who has gone into cardiac arrest, resulting in immediate resuscitative efforts. In this case, my mother’s patient was unable to be successfully resuscitated, and my mother had to call out the patient’s death.

“This patient had called me to tell me that she had seen death walk by, and was walking around the halls. She was afraid that it was coming for her and I told her no, it was for someone else.” she continued. “She went right back to sleep.”

“Death and the Miser” is considered to be a memento mori, or “reminder of death.” In depicting the physical manifestation of death, Bosch introduces the notion that death is mobile; it can show up in unfortunate places. The story presented by my mother and her patient illustrate a similar idea. You might see Death roaming the halls. You might see Death asking to enter a room. Yet, Death might not be there for you; it might be on its way to a code, to an outstretched hand, clad in white.